| NPI | 1861541146 |
|---|---|
| Former Name | LARRY S. NIJAKI |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA04357100) |
| Additional Taxonomies | 207NS0135X Dermatology Procedural Dermatology (Licence: NJ 25MA04357100) |
| 207ND0900X Dermatology Dermatopathology (Licence: NJ MA04357100) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2015-12-15 |