| NPI | 1467080929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: VA 0101288403) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2026-02-09 |