That's pretty much standard procedure. Patients are seen by the NP or PA. If something is detected or suspicious, either the doctor is consulted or a biopsy done. If surgery is indicated, the doctor does it. If Dr. Gurgen didn't have confidence in the capability of his NP or PA, they wouldn't be there. It's his license on the line.
I was a patient of Dr. Gurgen when he was at Advanced Dermatology. Took great care of me, including doing an enhancement on aprevious surgery done elsewhere that made the scar much less noticeable.
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"the difference between genius and stupidity is that genius has its limits."
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