| 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 |