| NPI | 1619364213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MO 2021014860) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 55015) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KS 0444880) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2022-05-16 |