| NPI | 1366988024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AZ 64024) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MO 2500061781) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2021-11-05 |