| NPI | 1932735925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: WY 18287A) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A181102) |
| Enumeration Date | 2020-03-21 |
| Last Update Date | 2026-08-31 |