| NPI | 1619203858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WI 56822-021) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS10384) |
| Enumeration Date | 2009-10-22 |
| Last Update Date | 2023-07-27 |