| NPI | 1235400177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: OR MD188428) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 113847) |
| Enumeration Date | 2012-01-24 |
| Last Update Date | 2018-06-05 |