NPI | 1578535506 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MN 38287) |
Additional Taxonomies | 207N00000X Dermatology (Licence: MN 38287) |
Enumeration Date | 2006-02-03 |
Last Update Date | 2021-02-03 |