| NPI | 1578717997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: WV 24872) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WV 24872) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MD D82097) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: MD D82097) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: VA 0101261587) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: MD D82097) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: WV 24872) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: WV 24872) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: MD D82097) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 236898) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 296329) | |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2022-11-18 |