| NPI | 1417185729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: MA 246728) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 240944) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2016-06-27 |