NPI | 1740359017 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: MD D0029651) |
Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0101033804) |
Enumeration Date | 2006-11-08 |
Last Update Date | 2025-05-12 |