| NPI | 1023266640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 67964) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KY 46766) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2024-01-25 |