NPI | 1689134348 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: MN 73965) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CA 4053) |
Enumeration Date | 2019-03-20 |
Last Update Date | 2023-08-01 |