| NPI | 1427081496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: FL ME 46912) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME 46912) |
| 207ND0900X Dermatology Dermatopathology (Licence: FL ME 46912) | |
| 207NS0135X Dermatology Procedural Dermatology (Licence: FL ME 46912) | |
| 207Q00000X Family Medicine (Licence: FL ME 46912) | |
| 208D00000X General Practice (Licence: FL ME 46912) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2020-08-28 |