| NPI | 1821035072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101042049) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101042049) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2022-08-15 |