| NPI | 1295930816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TN 46043) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA L-224527) |
| 207N00000X Dermatology (Licence: TN MD46043) | |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2022-03-28 |