| NPI | 1447756499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 323142) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: PA MD478556) |
| 207N00000X Dermatology (Licence: PA MD478556) | |
| 207N00000X Dermatology (Licence: NY 323142) | |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2023-12-17 |