| NPI | 1275038507 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: MA 1019384)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2018-03-28 | 
| Last Update Date | 2024-06-24 |