| NPI | 1922065424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101226879) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101226879) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2007-11-27 |