| NPI | 1801981576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NH 4579) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VT 6800) |
| 207ND0900X Dermatology, Dermatopathology (Licence: NH 4579) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: VT 6800) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2007-07-18 |