| NPI | 1023470788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 297600) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MO 2022013731) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KS 0445861) | |
| 207R00000X Internal Medicine (Licence: NY 297600) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2025-10-03 |