| NPI | 1750517736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: UT 8991267-1205) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 43502) |
| 207ND0900X Dermatology, Dermatopathology (Licence: UT 8991267-1205) | |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2023-11-27 |