NPI | 1619943644 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MD D51120) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: VA 101058507) |
Enumeration Date | 2006-02-28 |
Last Update Date | 2017-08-08 |