| NPI | 1669884383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME171810) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03051) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2025-02-17 |