| NPI | 1205220449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 69380) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: IL 036.146607) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2021-09-13 |