| NPI | 1881609741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G24865) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA G00024865) |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2022-08-23 |