NPI | 1639174220 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: NC 2007-00385) |
Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME 11708) |
Enumeration Date | 2005-06-20 |
Last Update Date | 2009-03-19 |