| NPI | 1689893703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA 000G60590) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA G60590) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2013-08-29 |