| NPI | 1770872632 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: CA A122044) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA E2515944) | 
| Enumeration Date | 2011-03-31 | 
| Last Update Date | 2016-11-29 |