NPI | 1841758810 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: OR DO198449) |
Additional Taxonomies | 207N00000X Dermatology (Licence: WA OP61137574) |
207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OR DO198449) | |
207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WA OP61137574) | |
Enumeration Date | 2019-03-07 |
Last Update Date | 2024-10-01 |