| NPI | 1043598352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 272143) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL OS15873) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NJ 25MB09502300) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: PA OS020863) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA 20A18457) | |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2023-09-28 |