| NPI | 1710197066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA OS014036) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: DE C2-0009087) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2023-05-10 |