NPI | 1184073801 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WI 75308-20) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CA A168460) |
207N00000X Dermatology (Licence: WI 75308-20) | |
207N00000X Dermatology (Licence: FL ME150285) | |
207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME150285) | |
Enumeration Date | 2016-06-03 |
Last Update Date | 2024-10-23 |