| NPI | 1881220739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: WI 87263-20) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: TX T6872) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 87263-20) | |
| Enumeration Date | 2020-03-22 |
| Last Update Date | 2026-07-07 |