NPI | 1801852678 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA07958900) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NJ 25MA07958900) |
Enumeration Date | 2006-04-21 |
Last Update Date | 2018-05-23 |