Overview
- Status: Inactive
- Category: Resident Physician
- Issue Date: July 01, 2018
- Effective Date: July 01, 2021
- Expiration Date: September 16, 2021
Type: INDIVIDUAL
Full Credential Code: 1.060630-RES
Credential Type: Yes
Credential Number: 60630
Credential Sub Category: RES
Status Reason: INACTIVE
Record Refresh: September 17, 2021