| NPI | 1003164427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: NY 292691) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125060758) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OK 31289) | |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2021-01-26 |