NPI | 1952565897 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: OH 35121523) |
Additional Taxonomies | 207N00000X Dermatology (Licence: MI 4301092937) |
Enumeration Date | 2008-07-10 |
Last Update Date | 2018-03-19 |