| NPI | 1063743722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: DE C1-0011583) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RH0003X Internal Medicine Hematology & Oncology (Licence: TX P3446) | |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2016-04-12 |