NPI | 1174624019 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: HI MD-5585) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: HI MD-5585) |
Enumeration Date | 2006-09-25 |
Last Update Date | 2020-09-25 |