| NPI | 1366929630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL L4830R) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AL L4830R) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2021-06-02 |