| NPI | 1508837394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AL MD.23613) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AL MD.23613) |
| 207ND0900X Dermatology, Dermatopathology (Licence: MD D0067723) | |
| 207N00000X Dermatology (Licence: MD D0067723) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2021-02-24 |