NPI | 1407864937 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OR MD19438) |
Additional Taxonomies | 207N00000X Dermatology (Licence: OR MD19438) |
Enumeration Date | 2006-08-03 |
Last Update Date | 2023-06-06 |