| NPI | 1306972120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 262834) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CT 67525) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 262834) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2024-08-14 |