| NPI | 1003904889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: FL ME104802) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN10057) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2025-03-05 |