NPI | 1659486587 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: NE 12664) |
Additional Taxonomies | 207N00000X Dermatology (Licence: IA 21857) |
Enumeration Date | 2006-08-20 |
Last Update Date | 2014-01-03 |