NPI | 1821441486 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: MI 4301501765) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MI 4301501765) |
207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: MI 4301501765) | |
Enumeration Date | 2016-07-19 |
Last Update Date | 2020-07-16 |