| NPI | 1932302932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 271057) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 271057) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2023-07-07 |