| NPI | 1447679865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A144007) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: CA A144007) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: CA A144007) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2086X0206X Surgery, Surgical Oncology (Licence: CA A144007) | |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2024-10-25 |