| NPI | 1861770786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: IL 036-147257-11) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57-01-9506) |
| 207R00000X Internal Medicine (Licence: OH 35-12-6693) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2022-03-17 |