| NPI | 1891149126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD205832) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: HI MD-22103) | |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: PA MD487829) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: IN Temp) | |
| Enumeration Date | 2016-04-23 |
| Last Update Date | 2026-07-02 |