| NPI | 1396868337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: AZ 26802) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: NC 0028521) |
| 207ND0900X Dermatology, Dermatopathology (Licence: AL MD.27538) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: FL ME86716) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: SC 19249) | |
| 207R00000X Internal Medicine (Licence: UT 173614-1205) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AZ 26802) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: AZ 26802) | |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: AZ 26802) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: SC 19249) | |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2008-06-19 |