| NPI | 1285374876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 3013516) |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2024-07-03 |