| NPI | 1043846066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 179201) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA 179201) | |
| Enumeration Date | 2020-03-21 |
| Last Update Date | 2026-05-07 |