| NPI | 1336842582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A208997) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: WA MD.MD.70012812) | |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2026-06-19 |