| NPI | 1760902936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: DE C1-0025525) |
| Additional Taxonomies | 207RA0201X Internal Medicine Allergy & Immunology (Licence: MD MD048091) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2023-06-29 |