| NPI | 1972869717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: IA DO-05403) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 262827) |
| 208M00000X Hospitalist (Licence: MA 262827) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2023-08-31 |