| NPI | 1871835173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: NC 2019-01994) |
| Additional Taxonomies | 207RH0000X Internal Medicine, Hematology (Licence: NC 2019-01994) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2022-06-09 |