| NPI | 1588169585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: FL OS20633) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RH0000X Internal Medicine, Hematology (Licence: FL OS20633) | |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2026-08-24 |