NPI | 1770715492 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: MD D0055151) |
Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: MD D0055151) |
Enumeration Date | 2009-08-13 |
Last Update Date | 2009-08-13 |