NPI | 1902288707 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: NE 31653) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 31653) |
207R00000X Internal Medicine (Licence: NE 7473) | |
Enumeration Date | 2015-06-29 |
Last Update Date | 2019-08-14 |