NPI | 1225327844 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MA 262856) |
Additional Taxonomies | 207N00000X Dermatology (Licence: MA 262856) |
Enumeration Date | 2011-04-04 |
Last Update Date | 2023-06-12 |