| NPI | 1770639353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: MA 274568) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: AZ 37390) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL-1462) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2024-01-15 |