| NPI | 1164488417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NJ 25MA07893300) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD417022) |
| 207N00000X Dermatology (Licence: NJ 25MA07893300) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: PA MD417022) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: NJ 25MA07893300) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2019-12-27 |