| NPI | 1285850784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: MN 59748) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD13676) |
| 208M00000X Hospitalist (Licence: RI LP00959) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2021-04-22 |