| NPI | 1962039164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology Allergy (Licence: NC 2023-00633) |
| Additional Taxonomies | 207RA0201X Internal Medicine Allergy & Immunology (Licence: NC 2023-00633) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2023-05-01 |