| NPI | 1114452679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: KY FL066) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: KY FL066) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2021-09-23 |