| NPI | 1902197064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 71695) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11016108A) |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2023-11-27 |