| NPI | 1164454237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: PA MD066026L) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: PA MD066026L) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2023-12-28 |