| NPI | 1932262433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MD H0092858) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207ZD0900X Pathology, Dermatopathology (Licence: TX N7325) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: MI 5101028889) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 229989) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: OH 34.010908) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2026-04-13 |