| NPI | 1003557745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A188177) |
| 207RH0003X Internal Medicine Hematology & Oncology (Licence: CA A188177) | |
| Enumeration Date | 2022-04-06 |
| Last Update Date | 2025-04-02 |