NPI | 1710095120 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207NS0135X Dermatology Procedural Dermatology (Licence: LA MD.200242) |
Additional Taxonomies | 207N00000X Dermatology (Licence: AL MD.27962) |
207N00000X Dermatology (Licence: LA MD.200242) | |
207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: AL MD.27962) | |
207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: LA MD.200242) | |
207ND0900X Dermatology Dermatopathology (Licence: AL MD.27962) | |
207ND0900X Dermatology Dermatopathology (Licence: LA MD.200242) | |
207NI0002X Dermatology Clinical & Laboratory Dermatological Immunology (Licence: AL MD.27962) | |
207NI0002X Dermatology Clinical & Laboratory Dermatological Immunology (Licence: LA MD.200242) | |
207NP0225X Dermatology Pediatric Dermatology (Licence: AL MD.27962) | |
207NP0225X Dermatology Pediatric Dermatology (Licence: LA MD.200242) | |
207NS0135X Dermatology Procedural Dermatology (Licence: AL MD.27962) | |
Enumeration Date | 2006-08-26 |
Last Update Date | 2020-09-10 |