| NPI | 1285366807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: RI LP06773) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 293730) |
| Enumeration Date | 2022-06-30 |
| Last Update Date | 2025-07-28 |