NPI | 1144297847 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME171272) |
Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35-049740) |
207N00000X Dermatology (Licence: OH 35-049740C) | |
207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OH 35-049740C) | |
Enumeration Date | 2006-03-02 |
Last Update Date | 2025-01-10 |