NPI | 1851340418 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NJ 25MA07918300) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NY 239603) |
207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 239603) | |
207NS0135X Dermatology, Procedural Dermatology (Licence: NY 239603) | |
Enumeration Date | 2006-05-09 |
Last Update Date | 2025-06-23 |