NPI | 1942516992 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: NC 2015-01306) |
Additional Taxonomies | 207N00000X Dermatology (Licence: GA 74221) |
Enumeration Date | 2010-08-27 |
Last Update Date | 2020-04-16 |