| NPI | 1851340418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 239603) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 239603) |
| 207N00000X Dermatology (Licence: NY 239603) | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2015-04-10 |