| NPI | 1306027842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: UT 9717129-1205) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: UT 9717129-1205) |
| 207R00000X Internal Medicine (Licence: LA MD.201983) | |
| 208000000X Pediatrics (Licence: LA MD.201983) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2023-09-11 |