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 |