NPI | 1952523474 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: MD H0075064) |
Additional Taxonomies | 207NP0225X Dermatology, Pediatric Dermatology (Licence: PA OS014763) |
Enumeration Date | 2007-05-03 |
Last Update Date | 2017-02-28 |