| NPI | 1548688989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: UT 6845592-1205) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MT MED-PHYS-LIC-76211) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MT MED-PHYS-LIC-76211) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MT 76211) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: MT MED-PHYS-LIC-76211) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2024-04-17 |