| 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 |