| NPI | 1841241205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G27106) |
| Additional Taxonomies | 207ND0900X Dermatology Dermatopathology (Licence: CA G27106) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2016-09-27 |