| NPI | 1568761427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: WI 71068) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036128537) |
| 207R00000X Internal Medicine (Licence: IA 40394) | |
| 207RH0000X Internal Medicine Hematology (Licence: MN 63694) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125056511) | |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2021-01-19 |