| NPI | 1780900167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OK 38918) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 254676) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 254676) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-11 |
| Last Update Date | 2022-07-01 |