| NPI | 1518195155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NV 26207) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036135383) |
| 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: NV 26207) | |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2024-09-23 |