| NPI | 1912983479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: PA MD038210E) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD038210E) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2014-08-05 |