| NPI | 1730640780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: DE C1-0027055) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: DE C1-0027055) |
| Enumeration Date | 2019-03-30 |
| Last Update Date | 2024-07-09 |