| NPI | 1922154798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A050367) |
| Additional Taxonomies | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: CA A050367) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2025-09-11 |