| NPI | 1538112305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CO DR.0018740) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: CO DR.0018740) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CO DR.0018740) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2021-02-12 |