| NPI | 1669908737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MI 5101027750) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MD H0095562) | |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2024-05-06 |