| NPI | 1164199469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: TX 48023) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10076747) |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2023-08-21 |