| NPI | 1932275724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MA 75055) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: DC MD037134) |
| 207N00000X Dermatology (Licence: DC MD037134) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: CA A048415) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A048415) | |
| 207N00000X Dermatology (Licence: CA A048415) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: DC MD037134) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: MA 75055) | |
| 207N00000X Dermatology (Licence: MA 75055) | |
| Enumeration Date | 2006-11-26 |
| Last Update Date | 2010-05-25 |