| NPI | 1679548440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX M2999) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IN 02002212A) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2024-01-26 |