| NPI | 1215450937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: SD 13945) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SD 13945) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2023-08-01 |