| NPI | 1396975850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX N8206) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS10591) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX N8206) | |
| 207R00000X Internal Medicine (Licence: TX N8206) | |
| Enumeration Date | 2009-07-19 |
| Last Update Date | 2014-02-11 |