| NPI | 1871542308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: UT 3085198-1205) |
| Additional Taxonomies | 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: UT 3085198-1205) |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: UT 3085198-1205) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: UT 3085198-1205) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2023-07-18 |