| NPI | 1619297769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology Dermatopathology (Licence: KS 04-37591) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: KS 04-37591) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2020-05-22 |