| NPI | 1750439188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 24271) |
| Additional Taxonomies | 207ND0900X Dermatology Dermatopathology (Licence: NC 24271) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2016-07-16 |