| NPI | 1659527190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 242817) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: MA 242817) |
| Enumeration Date | 2008-08-15 |
| Last Update Date | 2018-10-18 |