NPI | 1609296698 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: SC SC84163) |
Additional Taxonomies | 207N00000X Dermatology (Licence: SC SC84163) |
Enumeration Date | 2014-04-17 |
Last Update Date | 2023-06-07 |