NPI | 1316935521 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MD D0066740) |
Additional Taxonomies | 207N00000X Dermatology (Licence: MD D0066740) |
Enumeration Date | 2005-10-11 |
Last Update Date | 2011-03-11 |