NPI | 1447291356 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: IL 036124865) |
Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036124865) |
Enumeration Date | 2006-06-10 |
Last Update Date | 2017-08-03 |