| NPI | 1043242589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OH 35-089926) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35-089926) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MA 228008) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: OH 35-089926) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2020-12-17 |