| NPI | 1427378595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: VA 0102203164) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0102203164) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2024-09-27 |