NPI | 1629537576 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: IA R-11746) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA R-11746) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-03-19 |
Last Update Date | 2020-07-14 |