| NPI | 1801813621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 208782) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 208782) |
| 207ND0900X Dermatology, Dermatopathology (Licence: NY 208782) | |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: NY 208782) | |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2022-11-09 |