NPI | 1962405332 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: OH 35042672) |
Additional Taxonomies | 174400000X Specialist (Licence: OH 35042675) |
Enumeration Date | 2005-05-31 |
Last Update Date | 2011-05-20 |