| NPI | 1891355186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 1013828) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MA 1770504599) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2024-09-19 |