| NPI | 1902395601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351048906) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NM MD2025-0074) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-08 |
| Last Update Date | 2025-05-08 |