| NPI | 1518452127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MI 4301511313) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301511313) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY 54944) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2018013612) | |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2024-05-07 |