| NPI | 1760945810 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: PA MD488806) | 
| Additional Taxonomies | 207RH0000X Internal Medicine, Hematology (Licence: PA MD488806) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-06 | 
| Last Update Date | 2025-08-04 |