| NPI | 1770046146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: TX U8024) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP100668302) |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2024-04-26 |