| NPI | 1659766889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD472789) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA11500500) |
| 207R00000X Internal Medicine (Licence: WV 28245) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WV 28245) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2023-03-15 |