NPI | 1952393829 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: CO 36147) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CO DR.0036147) |
207NS0135X Dermatology Procedural Dermatology (Licence: CO 36147) | |
Enumeration Date | 2005-08-17 |
Last Update Date | 2024-01-09 |