| NPI | 1922290592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX L2818) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX L2818) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX L2818) | |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2024-05-21 |