NPI | 1245368695 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AK AK4179) |
Additional Taxonomies | 207N00000X Dermatology (Licence: AK AK4179) |
207ND0900X Dermatology, Dermatopathology (Licence: AK AK4179) | |
207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: AK AK4179) | |
207NP0225X Dermatology, Pediatric Dermatology (Licence: AK AK4179) | |
207NS0135X Dermatology, Procedural Dermatology (Licence: AK AK4179) | |
Enumeration Date | 2007-02-28 |
Last Update Date | 2009-02-10 |