| NPI | 1881078319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A171866) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: KS 9408775) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2022-09-19 |