| NPI | 1508092347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL 109786) |
| Additional Taxonomies | 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: FL 109786) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: FL 109786) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: FL 109786) | |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2014-07-30 |