| NPI | 1053440867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME102887) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 243174) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME102887) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 243174) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: NY 243174) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: FL ME102887) | |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: NY 243174) | |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: FL ME102887) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2019-11-07 |