NPI | 1023670783 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WV 34295) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 280966) |
Enumeration Date | 2019-07-02 |
Last Update Date | 2025-09-04 |