| NPI | 1114919503 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: FL ME68929)  | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TN 36771)  | 
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MS 17856)  | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AR E3595)  | |
| Enumeration Date | 2005-08-22 | 
| Last Update Date | 2023-04-28 |