| NPI | 1457729386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NY 28878) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 288748) |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: NY 288748) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2022-10-06 |