| 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 |