NPI | 1770141715 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0102206235) |
Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102206235) |
Enumeration Date | 2019-06-04 |
Last Update Date | 2024-08-23 |