NPI | 1942230925 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 27555) |
Additional Taxonomies | 207N00000X Dermatology (Licence: UT 5663814-1205) |
Enumeration Date | 2006-07-04 |
Last Update Date | 2015-11-12 |