| NPI | 1861757494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AZ 73271) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125060840) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 35.126105) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OH 35.126105) | |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2024-05-22 |