| NPI | 1497717532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: MD D0071005) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IN 01053651A) |
| 207N00000X Dermatology (Licence: MD D) | |
| 207N00000X Dermatology (Licence: MD D0071005) | |
| 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: IN 01053651A) | |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2020-10-05 |