| NPI | 1649299090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: OH 35-068611) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35-068611) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-12-17 |