NPI | 1649433152 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: MA 247358) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NY 254990) |
Enumeration Date | 2008-07-03 |
Last Update Date | 2019-09-18 |