| NPI | 1841280336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IA 31379) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 31379) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2020-11-16 |