| NPI | 1295927788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: AZ 4767) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 4767) |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2024-04-04 |