| NPI | 1265477681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX K9734) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: TX K9734) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2021-09-16 |