| NPI | 1760431654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A106295) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: DC MD036056) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2021-02-17 |