| NPI | 1770162190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: NH 39456) |
| Enumeration Date | 2021-04-04 |
| Last Update Date | 2026-05-12 |