| NPI | 1295231769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WI 82136) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 125.075232) |
| 207ND0900X Dermatology, Dermatopathology (Licence: SC MMD.87404) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: WI 82136) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2024-03-06 |