| NPI | 1437470382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX q0853) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10038239) |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2024-10-07 |