| NPI | 1326335985 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: GA 105236) | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MD D86367) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-07-05 | 
| Last Update Date | 2025-09-29 |