| NPI | 1043707003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NJ 25MA11789400) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 323010-01) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2023-09-28 |