| NPI | 1447288147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A86627) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A86627) |
| 207ZD0900X Pathology, Dermatopathology (Licence: CA A86627) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2020-10-06 |