| NPI | 1114440690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CO DR.0070149) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: LA 322504) |
| Enumeration Date | 2017-07-17 |
| Last Update Date | 2025-09-18 |