| NPI | 1770015349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 1019437) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD470153) |
| 208M00000X Hospitalist (Licence: PA MD470153) | |
| Enumeration Date | 2017-04-01 |
| Last Update Date | 2024-08-26 |