| NPI | 1902255276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX T5155) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: NC 2022-01073) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2022-09-13 |