| NPI | 1700071156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: GA 65192) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME104476) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN9842) | |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2019-01-23 |