| NPI | 1962844936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 293420) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: ZZ 5829) |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2018-05-16 |