| NPI | 1922065044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AR R3892) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AR R3892) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2022-07-05 |