| NPI | 1073615654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: NC 2012-00964) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301087311) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2013-05-16 |