| NPI | 1033224431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: ME 018570) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: IA 37789) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: IA 37789) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NH 12238) | |
| 207N00000X Dermatology (Licence: NH 12238) | |
| 207N00000X Dermatology (Licence: IA 37789) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2022-08-12 |