| NPI | 1154311082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 96-00095) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 9600095) |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: NC 9600095) | |
| Enumeration Date | 2005-10-22 |
| Last Update Date | 2015-10-23 |