NPI | 1689856049 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: CT 48603) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CT 390200000X) |
Enumeration Date | 2007-11-28 |
Last Update Date | 2015-08-24 |