NPI | 1578051009 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2021-02572) |
Additional Taxonomies | 207RH0000X Internal Medicine, Hematology (Licence: NC 2021-02572) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 238302) | |
Enumeration Date | 2018-04-30 |
Last Update Date | 2023-09-14 |