NPI | 1962713370 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: MA 257696) |
Additional Taxonomies | 207N00000X Dermatology (Licence: RI MD16925) |
Enumeration Date | 2010-06-30 |
Last Update Date | 2024-05-06 |