| NPI | 1457321028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME-89551) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME-89551) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2007-10-22 |