NPI | 1598178378 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 297978-1) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 297978-1) |
Enumeration Date | 2014-06-09 |
Last Update Date | 2020-10-26 |