NPI | 1417374406 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 67548) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2014-03-27 |
Last Update Date | 2020-10-07 |