| NPI | 1730137845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: LA MD.018423) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: LA 018423) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: LA 018423) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2014-05-28 |