| NPI | 1730612482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: NC 2024-02197) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AL 37756) | |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2024-08-21 |