NPI | 1508975731 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 242171) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NY 242171) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2023-07-06 |