| NPI | 1639580152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IN 01080087A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11017590A) |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2018-05-01 |