| NPI | 1104002195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: MT 12523) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 6808635-1205) |
| Enumeration Date | 2008-01-21 |
| Last Update Date | 2021-07-27 |