| NPI | 1306285267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AZ 52433) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301103710) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301103710) | |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2019-11-19 |