NPI | 1609847821 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WA MD0046124) |
Additional Taxonomies | 207N00000X Dermatology (Licence: WA MD0046124) |
207N00000X Dermatology (Licence: AZ 12532) | |
207N00000X Dermatology (Licence: CA 45899) | |
207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AZ 12532) | |
207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA 45899) | |
Enumeration Date | 2006-01-27 |
Last Update Date | 2020-09-29 |