NPI | 1699764993 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME59480) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME59480) |
207ND0900X Dermatology, Dermatopathology (Licence: FL ME59480) | |
207NS0135X Dermatology, Procedural Dermatology (Licence: FL ME59480) | |
Enumeration Date | 2005-10-19 |
Last Update Date | 2024-04-29 |