| NPI | 1447326293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: PA md430789) |
| Additional Taxonomies | 207NP0225X Dermatology, Pediatric Dermatology (Licence: DE c10006811) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: PA md430789) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: DE c10006811) | |
| 207N00000X Dermatology (Licence: PA MD430789) | |
| 207N00000X Dermatology (Licence: DE c10006811) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: DE c10006811) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: DE c10006811) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: PA md430789) | |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: PA md430789) | |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2021-05-19 |