NPI | 1336506260 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME144623) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME144623) |
207NS0135X Dermatology, Procedural Dermatology (Licence: FL ME14623) | |
Enumeration Date | 2016-01-22 |
Last Update Date | 2022-03-29 |