| NPI | 1275913006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: IL 036159949) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WI 73235) |
| Enumeration Date | 2015-06-06 |
| Last Update Date | 2024-05-10 |