NPI | 1861495012 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: TN 35668) |
Additional Taxonomies | 207NP0225X Dermatology, Pediatric Dermatology (Licence: TN 35668) |
207NS0135X Dermatology, Procedural Dermatology (Licence: TN 35668) | |
Enumeration Date | 2005-05-23 |
Last Update Date | 2007-07-08 |