| NPI | 1790515963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD484162) |
| Additional Taxonomies | 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: PA MD484162) |
| Enumeration Date | 2024-08-03 |
| Last Update Date | 2024-08-03 |