| NPI | 1134448079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: SC 40321) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT197543) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: SC 40321) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT197543) | |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2022-03-10 |