| NPI | 1699801308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: TX M9706) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA L-217520) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2009-05-21 |