NPI | 1528096831 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: SC 29232) |
Additional Taxonomies | 207N00000X Dermatology (Licence: LA 021882) |
207N00000X Dermatology (Licence: SC 29232) | |
207NS0135X Dermatology Procedural Dermatology (Licence: SC 29232) | |
Enumeration Date | 2006-06-28 |
Last Update Date | 2009-03-27 |