| NPI | 1427284710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX R1926) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX R1926) |
| 207ND0900X Dermatology, Dermatopathology (Licence: TX R1926) | |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: TX R1926) | |
| Enumeration Date | 2009-06-01 |
| Last Update Date | 2025-02-15 |