| NPI | 1265729834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: MN 65825) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: SC LL37214) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT198636) | |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2020-08-13 |