NPI | 1790826394 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: CA C163030) |
Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD448189) |
Enumeration Date | 2007-02-08 |
Last Update Date | 2022-06-07 |