| NPI | 1093245607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: UT 6878796-1204) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL UO7221) |
| 207R00000X Internal Medicine (Licence: MI 5101023411) | |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2023-06-01 |