NPI | 1649217936 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: CA G43543) |
Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA G43543) |
Enumeration Date | 2006-06-02 |
Last Update Date | 2014-03-10 |