| NPI | 1790814945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101280586) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A93124) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2024-02-02 |