| NPI | 1417246851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IN 02004576A) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: IN 02004576A) |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2021-02-17 |