| NPI | 1457573974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: SD 8325) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101244302) |
| 207RH0003X Internal Medicine Hematology & Oncology (Licence: MN 104308) | |
| 207RH0003X Internal Medicine Hematology & Oncology (Licence: MN 52164) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116017474) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2022-04-29 |