| NPI | 1003043704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: UT 9717170-1204) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL UO 3134) |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2021-09-16 |