| NPI | 1558724013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: NH 31005) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AZ 60394) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2024-08-28 |