| NPI | 1720124233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD434138) |
| Additional Taxonomies | 207ND0900X Dermatology Dermatopathology (Licence: PA MD434138) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2023-03-27 |