| NPI | 1538346911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A97551) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A97551) |
| 207P00000X Emergency Medicine (Licence: CA a97551) | |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2017-04-06 |