| NPI | 1760738363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NV 17307) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP1-0037578) |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2018-07-24 |