| NPI | 1447410246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101287658) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MD D0086148) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: DC MD046568) | |
| Enumeration Date | 2008-06-15 |
| Last Update Date | 2025-10-07 |