NPI | 1295727048 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: AL 18046) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AL 18046) |
207ND0900X Dermatology, Dermatopathology (Licence: AL 18046) | |
Enumeration Date | 2005-08-18 |
Last Update Date | 2008-05-13 |