| NPI | 1861727802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TN 50377) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: GA 070656) |
| Enumeration Date | 2009-10-08 |
| Last Update Date | 2024-05-13 |