| NPI | 1952836108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OR DO198464) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR PG193979) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2023-08-04 |