NPI | 1043605173 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OH 35.138954) |
Additional Taxonomies | 207N00000X Dermatology (Licence: IN 01081795A) |
207N00000X Dermatology (Licence: OH 35.138954) | |
207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: IN 01081795A) | |
Enumeration Date | 2015-04-06 |
Last Update Date | 2022-03-15 |