| NPI | 1790756302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 41945) |
| Additional Taxonomies | 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: MN 41945) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2020-08-14 |