| NPI | 1063617348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: MN 60131) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 60131) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 60131) | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2023-08-15 |