| NPI | 1982802245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MI AC093636) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: IL 036.118454) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2010-08-20 |