NPI | 1831326941 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: UT 373544-1205) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CA A108313) |
207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: UT 373544-1205) | |
Enumeration Date | 2009-06-16 |
Last Update Date | 2021-12-14 |