NPI | 1902815491 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: OH 35048010) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OH 35048010) |
Enumeration Date | 2006-08-05 |
Last Update Date | 2021-02-22 |