| NPI | 1699115824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2019-1033) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX V0863) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX V0863) | |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: TX V0863) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2024-07-10 |