| NPI | 1558781807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A143055) |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2018-08-15 |