| NPI | 1457586208 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: VA 0101257665)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME113141)  | 
| 207RH0000X Internal Medicine, Hematology (Licence: VA 0101257665)  | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-05-22 | 
| Last Update Date | 2019-12-19 |