| NPI | 1447612080 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A176734)  | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OK 34879)  | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-23 | 
| Last Update Date | 2022-03-25 |