| NPI | 1699099671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 269373) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD451382) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NJ 25MA09654300) | |
| 207N00000X Dermatology (Licence: NY 269373) | |
| 207N00000X Dermatology (Licence: NJ 25MA09654300) | |
| Enumeration Date | 2010-03-20 |
| Last Update Date | 2022-01-02 |