| NPI | 1811699093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CO in-training) |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2026-07-04 |