| NPI | 1023155827 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: MD D67993)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D67993)  | 
| Enumeration Date | 2007-01-31 | 
| Last Update Date | 2016-07-25 |