| NPI | 1063108678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OK None) |
| Enumeration Date | 2023-04-17 |
| Last Update Date | 2026-05-19 |