NPI | 1851355184 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME33849) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NC 2014-01177) |
Enumeration Date | 2006-04-13 |
Last Update Date | 2019-10-17 |