| NPI | 1306173679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: MN 54767) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2009-11-07 |
| Last Update Date | 2020-10-27 |