| NPI | 1871705699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: KS 0431214) |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: KS 04-31214) |
| 207ND0900X Dermatology Dermatopathology (Licence: KS 04-31214) | |
| 207ND0900X Dermatology Dermatopathology (Licence: MO 2020000004) | |
| 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: IN 01062202A) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2023-03-16 |