| NPI | 1831355833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: GA 069545) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207K00000X Allergy & Immunology (Licence: TN 45398) | |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2014-02-05 |