| NPI | 1932561925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: CA A149661) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A149661) |
| 207ZD0900X Pathology, Dermatopathology (Licence: CA A149661) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2023-10-14 |