NPI | 1861495061 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD018193E) |
Additional Taxonomies | 207N00000X Dermatology (Licence: WI 60705 - 20) |
Enumeration Date | 2005-05-23 |
Last Update Date | 2024-11-30 |