| NPI | 1447767397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: DC MD600004337) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: DC MD600004337) |
| 207N00000X Dermatology (Licence: DC MTL500001735) | |
| Enumeration Date | 2018-01-01 |
| Last Update Date | 2026-08-04 |