| NPI | 1104107622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine Medical Oncology (Licence: NY 301965) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-247883) |
| 207R00000X Internal Medicine (Licence: NY 301965) | |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2020-01-17 |