| NPI | 1417073503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL OS15357) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AL DO.2669) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL OS15357) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AL DO.2669) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2023-12-29 |