| NPI | 1265584692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A55737) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A55737A) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2025-05-30 |