| NPI | 1831150093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: VA 0101231236) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: MD D0008353) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2007-07-08 |