| NPI | 1093344327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NY 323842) |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2025-05-15 |