| NPI | 1922275809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 232075) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 232075) |
| Enumeration Date | 2008-05-10 |
| Last Update Date | 2023-08-14 |