| NPI | 1205088630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PR 18344) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 18344) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2016-01-11 |