NPI | 1710048483 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: CA A086935) |
Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA A086935) |
Enumeration Date | 2006-12-13 |
Last Update Date | 2013-09-09 |