NPI | 1942414115 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: PA MD432947) |
Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: PA MD432947) |
207N00000X Dermatology (Licence: PA MD432947) | |
207ND0900X Dermatology, Dermatopathology (Licence: PA MD432947) | |
Enumeration Date | 2007-05-09 |
Last Update Date | 2009-01-26 |