| NPI | 1437447745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ R76653) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S019814) |
| 207R00000X Internal Medicine (Licence: AZ R76653) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ I009315) | |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2019-08-28 |