| NPI | 1902175615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine Medical Oncology (Licence: IA MD-42799) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RX0202X Internal Medicine Medical Oncology (Licence: GA 005778) | |
| Enumeration Date | 2011-12-26 |
| Last Update Date | 2015-09-08 |