| NPI | 1194838045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 4301079801) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036113849) |
| 207N00000X Dermatology (Licence: IN 01084831A) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: IL 036113849) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: IL 036113849) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2020-10-23 |