| NPI | 1992113054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: CO DR.0070300) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 260624) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2023-04-15 |