NPI | 1033505243 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: IL 036.149833) |
Additional Taxonomies | 207N00000X Dermatology (Licence: MN 62406) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-04-14 |
Last Update Date | 2019-07-29 |