| NPI | 1578927356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: GA 100896) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 100896) |
| 207R00000X Internal Medicine (Licence: OH 35.135676) | |
| 207RH0000X Internal Medicine, Hematology (Licence: TN 63536) | |
| 208000000X Pediatrics (Licence: GA 100896) | |
| 208000000X Pediatrics (Licence: TN 63536) | |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TN 63536) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2024-07-12 |