| NPI | 1356508352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX U2018) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX U2018) |
| 207ND0900X Dermatology, Dermatopathology (Licence: AL 33208) | |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2024-02-12 |