| NPI | 1619276177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: HI MD-19180) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: NV 15757) |
| 207N00000X Dermatology (Licence: OR MD176186) | |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2021-05-27 |