| NPI | 1942647078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NJ 25MA11001800) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD460432) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: PA MD460432) | |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2021-04-15 |