| NPI | 1053639880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: NC 2025-01879) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN14651) |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: FL ME119738) | |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: MN 61400) | |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2025-10-05 |