| NPI | 1104169358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: MD D82104) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D82104) |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2020-04-22 |