| NPI | 1366901688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A178244) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: NY 330949) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-16 |
| Last Update Date | 2025-08-14 |