NPI | 1700114931 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NJ 25MA09876100) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207R00000X Internal Medicine (Licence: MI 4301100363) | |
Enumeration Date | 2009-11-29 |
Last Update Date | 2017-03-27 |