NPI | 1497098644 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A133196) |
Additional Taxonomies | 207N00000X Dermatology (Licence: MN 61767) |
207N00000X Dermatology (Licence: CA A133196) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2013-04-05 |
Last Update Date | 2021-12-03 |