NPI | 1508811076 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: IA 26772) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: IA 26772) |
207NP0225X Dermatology, Pediatric Dermatology (Licence: IA 26772) | |
207NS0135X Dermatology, Procedural Dermatology (Licence: IA 26772) | |
Enumeration Date | 2006-05-23 |
Last Update Date | 2007-11-28 |