NPI | 1205805405 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OR MD28318) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WI 24071) |
Enumeration Date | 2006-03-17 |
Last Update Date | 2022-12-27 |