| NPI | 1629211982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA OS016804) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OH 34.010019) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-15 |
| Last Update Date | 2021-10-29 |