| NPI | 1669993747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IN 02006986A) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 34.015247) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2024-01-31 |