| NPI | 1720044134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: RI MD14522) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 205049) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2025-12-17 |