| NPI | 1972008605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A165492) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD475189) |
| 207RH0000X Internal Medicine, Hematology (Licence: CA A165492) | |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: CA A165492) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2025-03-22 |