| NPI | 1710392477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: KY 50117) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY R3588) |
| 207RH0000X Internal Medicine, Hematology (Licence: KY 50117) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-21 |
| Last Update Date | 2020-12-07 |