NPI | 1407113038 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME127944) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2012-04-20 |
Last Update Date | 2019-05-10 |