| NPI | 1699902726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NV 14618) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: OR MD185082) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2021-11-09 |