| NPI | 1487006813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A188614) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125068361) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2020-0510) | |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2023-08-11 |