| NPI | 1861489106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX U0395) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: ID M-8852) |
| 207N00000X Dermatology (Licence: AZ 67944) | |
| 207N00000X Dermatology (Licence: CA A116923) | |
| 207N00000X Dermatology (Licence: UT 13011731-1205) | |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2024-06-05 |