| NPI | 1437738069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 342029) |
| 207ND0900X Dermatology, Dermatopathology (Licence: NY 342029) | |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2026-03-02 |