| NPI | 1275710758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME101561) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME101561) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: IL 036118526) | |
| Enumeration Date | 2008-01-27 |
| Last Update Date | 2022-08-18 |