| NPI | 1841794393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 92577) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: GA 92577) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2023-05-17 |