NPI | 1992086102 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: KY 51117) |
Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35.134519) |
207N00000X Dermatology (Licence: FL ME134214) | |
207R00000X Internal Medicine (Licence: AZ R72811) | |
Enumeration Date | 2011-08-31 |
Last Update Date | 2020-09-04 |