| NPI | 1952527319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A104470) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: LA MD.200915) |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: CA A104470) | |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: LA MD.200915) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: LA MD.200915) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: CA A104470) | |
| 207R00000X Internal Medicine (Licence: LA MD.200915) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2023-11-01 |