| NPI | 1174783385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NC 2012-02257) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: SC MD39964) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2016-09-13 |