| NPI | 1316474471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AR E-16103) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OK 33036) |
| 207N00000X Dermatology (Licence: AR E-16103) | |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2023-05-17 |