| NPI | 1124514682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A191911) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 01082871A) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2024-04-23 |