| NPI | 1437773892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT226482) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR PG198810) |
| 207N00000X Dermatology (Licence: PA MD488052) | |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2025-05-03 |