| NPI | 1194818948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CO DR.0048310) |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: CO DR.0048310) |
| 207NS0135X Dermatology Procedural Dermatology (Licence: CO DR.0048310) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2022-05-23 |