| NPI | 1003300732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: FL ME178692) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 276511) |
| Enumeration Date | 2018-06-16 |
| Last Update Date | 2026-06-24 |