NPI | 1275571028 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA G58478) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CA G58478) |
207ND0900X Dermatology, Dermatopathology (Licence: CA G58478) | |
207NS0135X Dermatology, Procedural Dermatology (Licence: CA G58478) | |
Enumeration Date | 2006-06-03 |
Last Update Date | 2020-10-12 |