| NPI | 1891946646 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME102364) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2008-10-09 | 
| Last Update Date | 2019-06-28 |