| NPI | 1043461817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: ID O-0785) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL2972) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KS 0535122) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: ID O-0785) | |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2016-06-08 |