| NPI | 1699873745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207NP0225X Dermatology, Pediatric Dermatology (Licence: MA 41583) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 41583) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-08-15 |