| NPI | 1073839932 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: TN 53372)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2010-04-15 | 
| Last Update Date | 2022-03-16 |