| NPI | 1730676669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TN 68087) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: TN 68087) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2025-02-14 |