| NPI | 1841600491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: MO 2019035104) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2020-06-09 |