| NPI | 1194399519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: MA 1019580) |
| Enumeration Date | 2021-05-19 |
| Last Update Date | 2026-04-09 |