| NPI | 1861492415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: PA MD019908E) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 1462051) |
| 207N00000X Dermatology (Licence: CT 020728) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: PA MD019908E) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX H6769) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: PA MD019908E) | |
| 207N00000X Dermatology (Licence: MD D0064913) | |
| 207N00000X Dermatology (Licence: DE C1-0008066) | |
| 171100000X Acupuncturist (Licence: PA PAK000066) | |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: PA 001240) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: PA 09421500) | |
| 207R00000X Internal Medicine (Licence: PA MD019908E) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: PA MD019908E) | |
| 208200000X Plastic Surgery (Licence: PA 09421500) | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2012-06-20 |