| NPI | 1487002267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: NC 2023-01945) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116029273) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2023-01945) | |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2024-07-11 |