| NPI | 1770803645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: NE 29950) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301096611) |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2017-09-15 |