| NPI | 1992125934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: NC 2022-02897) |
| Additional Taxonomies | 207RX0202X Internal Medicine Medical Oncology (Licence: NC 2022-02897) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2023-08-24 |