| NPI | 1801103643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: TN 55735) |
| Additional Taxonomies | 207RH0003X Internal Medicine Hematology & Oncology (Licence: MS 24958) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2018-03-17 |