| NPI | 1821446097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 94436) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO4907) |
| 207ND0900X Dermatology, Dermatopathology (Licence: GA 94436) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: GA 94436) | |
| Enumeration Date | 2016-05-28 |
| Last Update Date | 2023-11-06 |