NPI | 1093961971 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: NC 2023-00795) |
Additional Taxonomies | 207N00000X Dermatology (Licence: AL 42342) |
207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NC 2023-00795) | |
207R00000X Internal Medicine (Licence: MN 51900) | |
Enumeration Date | 2008-08-12 |
Last Update Date | 2023-07-13 |