| NPI | 1568848901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AL 43054) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MI 4301502535) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX T0984) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301107531) | |
| Enumeration Date | 2015-08-08 |
| Last Update Date | 2021-12-13 |