| NPI | 1194101840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL OS16586) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL OS16586) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: GA 82706) | |
| 207N00000X Dermatology (Licence: GA 82706) | |
| Enumeration Date | 2015-08-05 |
| Last Update Date | 2024-08-26 |