| NPI | 1871560045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MO R3G92) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO R3G92) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2023-05-15 |