| NPI | 1457855835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NC 248983) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NC 202300116) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2023-12-14 |