| NPI | 1972871374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX T2053) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP00007646) |
| 207R00000X Internal Medicine (Licence: TX T2053) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2022-08-05 |