| NPI | 1558629659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME141328) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME141328) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME141328) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2020-02-25 |