| NPI | 1689692576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: HI MD-21397) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: UT 2761741205) |
| 207ND0900X Dermatology, Dermatopathology (Licence: UT 2761741205) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: UT 276174-1205) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 276174-1205) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2021-10-28 |