| NPI | 1760042089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MO 2021017633) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2019022499) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2021-06-22 |