| NPI | 1174014955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OH 35.148817) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: CO TL.0008509) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125072134) | |
| 207R00000X Internal Medicine (Licence: IL 125072134) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL.0008509) | |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2023-07-07 |