| NPI | 1831236116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CO 51371) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 52199) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 104309) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL-1935) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN 104309) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2022-07-21 |