| NPI | 1811961600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 057047) |
| Additional Taxonomies | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: GA 057047) |
| 207NS0135X Dermatology Procedural Dermatology (Licence: GA 057047) | |
| 207ND0900X Dermatology Dermatopathology (Licence: GA 057047) | |
| 207NI0002X Dermatology Clinical & Laboratory Dermatological Immunology (Licence: GA 057047) | |
| 207NP0225X Dermatology Pediatric Dermatology (Licence: GA 057047) | |
| 183500000X Pharmacist (Licence: GA 057047) | |
| 208D00000X General Practice (Licence: GA 057047) | |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2024-05-03 |