| NPI | 1225474117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD475322) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301102895) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 283523) | |
| Enumeration Date | 2013-05-17 |
| Last Update Date | 2023-02-28 |