| NPI | 1891435905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OR PG215466) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10079167) |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2023-09-12 |