| NPI | 1710364401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: NC 2020-04197) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A144417) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2022-10-20 |