| NPI | 1801324256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: VA 0102205524) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207K00000X Allergy & Immunology (Licence: PA OS025841) | |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2026-09-21 |