| NPI | 1336536994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: AZ 008976) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 04272) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2025-01-03 |