NPI | 1598713935 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NE 20304) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NE 20304) |
Enumeration Date | 2006-05-05 |
Last Update Date | 2011-07-11 |