NPI | 1750575247 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A118111) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CA A118111) |
Enumeration Date | 2007-08-28 |
Last Update Date | 2021-01-06 |