NPI | 1134159627 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: TX J9612) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX J9612) |
Enumeration Date | 2006-07-03 |
Last Update Date | 2020-09-15 |