NPI | 1699182881 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 299294) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NY 299294) |
Enumeration Date | 2014-07-19 |
Last Update Date | 2019-08-19 |