| NPI | 1053751800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AZ 62474) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A141219) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: DC MTL001825) | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2021-11-02 |