NPI | 1902901226 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: CA A24262) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A24262) |
207ND0900X Dermatology, Dermatopathology (Licence: CA A24262) | |
207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: CA A24262) | |
207NP0225X Dermatology, Pediatric Dermatology (Licence: CA A24262) | |
207NS0135X Dermatology, Procedural Dermatology (Licence: CA A24262) | |
Enumeration Date | 2006-09-13 |
Last Update Date | 2007-07-08 |