| NPI | 1811182470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: PA MD441509) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 233984) |
| 207N00000X Dermatology (Licence: PA MD441509) | |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2015-10-05 |