| NPI | 1538653217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: PA MD482446) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25MA11878200) |
| 207N00000X Dermatology (Licence: PA MD482446) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NJ 25MA11878200) | |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2024-02-10 |