| NPI | 1164888368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: TX V3071) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 276360) |
| Enumeration Date | 2016-01-05 |
| Last Update Date | 2024-09-10 |