| NPI | 1164580973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: IN 01063061A) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IN 01063061A) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: IN 01063061A) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2024-02-01 |