| NPI | 1285772152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA G42229) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA G42229) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2024-08-30 |