NPI | 1811988736 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: NC 2007-01039) |
Additional Taxonomies | 174400000X Specialist (Licence: GA 060064) |
207N00000X Dermatology (Licence: GA 060064) | |
207NP0225X Dermatology, Pediatric Dermatology (Licence: GA 060064) | |
207NS0135X Dermatology, Procedural Dermatology (Licence: GA 060064) | |
208D00000X General Practice (Licence: GA 060064) | |
Enumeration Date | 2005-10-31 |
Last Update Date | 2022-06-16 |