| NPI | 1023219698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: MO 2013021419) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME105529) |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: NV Number Pending) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2013-07-19 |