| NPI | 1609860907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IA 21579) |
| Additional Taxonomies | 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: IA 21579) |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2007-11-27 |