| NPI | 1518464155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OH 35.154317) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35.154317) |
| 207N00000X Dermatology (Licence: IL 036170992) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: IL 036170992) | |
| 207R00000X Internal Medicine (Licence: OH 35.154317) | |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2025-09-02 |