| NPI | 1982629556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD054336L) |
| Additional Taxonomies | 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: PA MD054336L) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2015-11-09 |