| NPI | 1164545166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: RI DO01032) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: HI DOS-1007) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MA 243103) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OR DO157812) | |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2020-08-11 |