| NPI | 1336432756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101253068) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: VA 0101253068) | |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2018-07-17 |