| NPI | 1023542115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: GA 88583) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: GA 88583) | |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2026-01-12 |