NPI | 1700861382 |
---|---|
Other Name | TED MAJOR RUDOLPH |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME79805) |
Additional Taxonomies | 207NP0225X Dermatology, Pediatric Dermatology (Licence: FL ME79805) |
207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME79805) | |
207NS0135X Dermatology, Procedural Dermatology (Licence: FL ME79805) | |
Enumeration Date | 2005-12-07 |
Last Update Date | 2020-09-14 |