| NPI | 1396002325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2019-00566) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2019-00566) |
| 207R00000X Internal Medicine (Licence: TN 56733) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2020-11-13 |