| 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 |