| NPI | 1932692373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX T7634) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: TX T7634) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2024-03-04 |