NPI | 1083131395 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: FL OS16260) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL 16260) |
Enumeration Date | 2017-08-28 |
Last Update Date | 2024-08-15 |