NPI | 1780999805 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: NC 00258) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NC 00258) |
208D00000X General Practice (Licence: FL UO2522) | |
Enumeration Date | 2010-08-12 |
Last Update Date | 2021-03-31 |