NPI | 1013446780 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: IA MD-50169) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MN 64406) |
207ND0900X Dermatology, Dermatopathology (Licence: IA MD-50169) | |
207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: IA MD-50169) | |
207NP0225X Dermatology, Pediatric Dermatology (Licence: IA MD-50169) | |
207NS0135X Dermatology, Procedural Dermatology (Licence: IA MD-50169) | |
207N00000X Dermatology (Licence: MN 64406) | |
207N00000X Dermatology (Licence: IA MD-50169) | |
Enumeration Date | 2017-06-07 |
Last Update Date | 2022-09-16 |