NPI | 1346281250 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MN 26385) |
Additional Taxonomies | 174400000X Specialist (Licence: MN 26385) |
Enumeration Date | 2006-06-10 |
Last Update Date | 2022-08-22 |