NPI | 1528044229 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME104496) |
Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME104496) |
Enumeration Date | 2005-12-15 |
Last Update Date | 2024-05-21 |