| NPI | 1093128456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: MD D0092368) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NY 333703) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2025-03-17 |