NPI | 1336671429 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD480936) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25MA11108600) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-03-29 |
Last Update Date | 2023-05-09 |