| NPI | 1861553729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA 97000) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 231378) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NJ 25MA07573600) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2021-12-20 |