NPI | 1295784023 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A74875) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CA A74875) |
Enumeration Date | 2006-05-09 |
Last Update Date | 2011-11-18 |