| NPI | 1720617582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA A185667) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A185667) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR PG206374) | |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2025-07-16 |