| NPI | 1245237288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 134469) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 1344691) |
| Enumeration Date | 2005-07-06 |
| Last Update Date | 2022-09-01 |