| NPI | 1811564172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0106667) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MD D0106667) | |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2026-06-16 |