| NPI | 1427370352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NC 201702209) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35 095191) |
| 207N00000X Dermatology (Licence: FL ME126309) | |
| 207N00000X Dermatology (Licence: NC 2017-02209) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME126309) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OH 35.095191) | |
| Enumeration Date | 2010-02-19 |
| Last Update Date | 2020-09-29 |