| NPI | 1992956247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME127870) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: FL ME127870) |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2025-06-12 |