| NPI | 1487181285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: HI MD-22338) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207N00000X Dermatology (Licence: MN 66576) | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2022-08-16 |