NPI | 1891700332 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: CA A52535) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CA A52535) |
207NS0135X Dermatology Procedural Dermatology (Licence: CA A52535) | |
Enumeration Date | 2006-07-31 |
Last Update Date | 2015-08-04 |