| NPI | 1831148485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 200600105) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MD D058240) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2023-11-27 |