NPI | 1942201702 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: CA G66560) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA G66560) |
Enumeration Date | 2005-08-02 |
Last Update Date | 2024-01-19 |