NPI | 1548302615 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: VA 0101242335) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: LA 308166) |
Enumeration Date | 2007-02-13 |
Last Update Date | 2018-10-10 |