NPI | 1699234583 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: WV 33819) |
Additional Taxonomies | 207ND0900X Dermatology Dermatopathology (Licence: WV 33819) |
Enumeration Date | 2019-03-19 |
Last Update Date | 2024-08-22 |