| NPI | 1780845768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: CO DR.006833) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: CT 53282) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2022-09-27 |