| NPI | 1336496785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CO DR.0064912) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 6718920) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT200983) | |
| Enumeration Date | 2012-08-04 |
| Last Update Date | 2021-02-04 |