| NPI | 1902845720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MO 2006009464) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: KS 31651) |
| 207N00000X Dermatology (Licence: IN 01059923A) | |
| 207ZD0900X Pathology Dermatopathology (Licence: KS 31651) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2019-10-21 |