| NPI | 1932133659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AL 17253) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: GA 33617) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2024-01-22 |