| NPI | 1083052872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AZ 006549) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: AZ 6549) |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: OR PG163096) | |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2025-02-20 |