| NPI | 1023499076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: SC 86266) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: SC Pending) |
| 207R00000X Internal Medicine (Licence: MS T-2998) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2021-07-01 |