| NPI | 1124446554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 296429-1) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 296429-1) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2024-08-08 |