| NPI | 1427263441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MD 390200000X) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 257088-1) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 257088-1) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 257088-1) | |
| Enumeration Date | 2007-05-12 |
| Last Update Date | 2020-01-15 |