NPI | 1356845523 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: OR MD223656) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25MA11464700) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-03-21 |
Last Update Date | 2025-04-14 |