NPI | 1346432226 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: ID M10198) |
Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: ID M10198) |
207NS0135X Dermatology Procedural Dermatology (Licence: ID M10198) | |
Enumeration Date | 2007-08-14 |
Last Update Date | 2009-03-27 |