| NPI | 1023547601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: NJ 25MA11419400) |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: NY 310362) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2023-05-04 |