| NPI | 1881613792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NH 3488) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VT 042-0006880) |
| 207ND0900X Dermatology, Dermatopathology (Licence: NH 3488) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: VT 042-0006880) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2012-12-05 |