| NPI | 1710284393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MD D79526) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX P3190) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2015-09-30 |