| NPI | 1083020440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: MN 70935) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.027828) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2023-04-24 |