NPI | 1356977359 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: TX U3310) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX U3310) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-03-21 |
Last Update Date | 2025-06-11 |