| NPI | 1821364019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CT 60343) |
| Additional Taxonomies | 207RH0000X Internal Medicine, Hematology (Licence: CT 60343) |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: CT 60343) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-01 |
| Last Update Date | 2021-03-02 |