| NPI | 1003935081 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: NE 563) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE TEP) | 
| Enumeration Date | 2007-03-28 | 
| Last Update Date | 2013-06-17 |