| NPI | 1679061907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX T3451) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T3451) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2024-04-09 |