| NPI | 1063791119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MD D0093602) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101261596) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2022-10-21 |