| NPI | 1346633161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AZ 007930) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 007930) |
| Enumeration Date | 2015-03-18 |
| Last Update Date | 2024-09-05 |