| NPI | 1851755490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: NY 289933) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 289933) |
| Enumeration Date | 2016-04-10 |
| Last Update Date | 2025-05-05 |