NPI | 1780902585 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: NY 262147) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25MA09583800) |
Enumeration Date | 2010-05-04 |
Last Update Date | 2022-10-13 |