| NPI | 1720041569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD044569L) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: PA MD044569L) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2009-10-20 |