| NPI | 1366733156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 276184) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NJ 25MA09733400) | |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2022-01-12 |