| NPI | 1548623903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OH 35145374) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: MN 77766) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-03 |
| Last Update Date | 2024-09-10 |