| NPI | 1922093855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology Dermatopathology (Licence: OH 35058313H) |
| Additional Taxonomies | 207ND0900X Dermatology Dermatopathology (Licence: OH 35-058313H) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2008-09-02 |