| NPI | 1720183742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: KS 0427386) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX J0974) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2020-04-14 |