| NPI | 1982133633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AL MD.37350) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125070892) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2022-02-28 |