| NPI | 1083904197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine Medical Oncology (Licence: FL ME128271) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME128271) |
| 207RH0003X Internal Medicine Hematology & Oncology (Licence: FL ME128271) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-10 |
| Last Update Date | 2019-10-07 |