| NPI | 1467488510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CT 044189) |
| Additional Taxonomies | 207NP0225X Dermatology, Pediatric Dermatology (Licence: CT 044189) |
| 207N00000X Dermatology (Licence: CT 044189) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2024-05-06 |