NPI | 1992762017 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA07911600) |
Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: NJ 25MA07911600) |
207ND0900X Dermatology, Dermatopathology (Licence: NJ 25MA07911600) | |
207NP0225X Dermatology, Pediatric Dermatology (Licence: NJ 25MA07911600) | |
207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NJ 25MA07911600) | |
Enumeration Date | 2006-05-01 |
Last Update Date | 2017-01-26 |