| NPI | 1760686521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.011123) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AZ 41835) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2017-11-16 |