| NPI | 1164084117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 1025317) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 1025317) | |
| Enumeration Date | 2019-06-30 |
| Last Update Date | 2026-02-18 |