| NPI | 1164460994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: KS 04-19680) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: KS 04-19680) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2017-08-04 |