| NPI | 1174935431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2018-00466) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: NC 2018-00466) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301105106) | |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2022-10-20 |