NPI | 1619963162 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: MD D0063201) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MD D0063201) |
Enumeration Date | 2005-09-21 |
Last Update Date | 2024-05-03 |