| NPI | 1942681234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: MI 4301117492) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301108045) |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2022-12-06 |