NPI | 1790878866 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NJ 25MA08549700) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NY MD244214) |
Enumeration Date | 2006-10-02 |
Last Update Date | 2021-05-19 |