| NPI | 1023679859 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: MO 2021006235)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2021006235)  | 
| Enumeration Date | 2019-06-24 | 
| Last Update Date | 2025-08-06 |