| NPI | 1154845394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: MN 61652) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2018-07-03 |