| NPI | 1184003006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NC 2020-02860) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NC 02860) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207N00000X Dermatology (Licence: NC 2020-02860) | |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2021-11-04 |