| NPI | 1669634200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 47813) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 256396) |
| 207ND0900X Dermatology, Dermatopathology (Licence: AZ 47813) | |
| 207R00000X Internal Medicine (Licence: PA MT193444) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2024-04-23 |