| NPI | 1316474976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IL 036.156711) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IA R-11187) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA R-11187) | |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2022-11-23 |