NPI | 1255868410 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD61185433) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2017-05-18 |
Last Update Date | 2023-07-10 |