| NPI | 1467986059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD488226) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 064400) |
| 208M00000X Hospitalist (Licence: CT 064400) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: 57983) | |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2025-07-16 |