| NPI | 1013595743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 191561) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: CA 191561) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2026-06-01 |