NPI | 1629006630 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: LA 013362) |
Additional Taxonomies | 207NP0225X Dermatology, Pediatric Dermatology (Licence: LA 013362) |
207NS0135X Dermatology, Procedural Dermatology (Licence: LA 013362) | |
Enumeration Date | 2006-06-29 |
Last Update Date | 2010-02-09 |