| NPI | 1386183218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: GA 91572) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: GA 91572) | |
| Enumeration Date | 2017-02-12 |
| Last Update Date | 2023-11-02 |