| NPI | 1841313020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 005480) |
| Additional Taxonomies | 208D00000X General Practice (Licence: OH 58.002277) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2023-03-13 |