| NPI | 1164663878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine Medical Oncology (Licence: CA A112751) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A112751) |
| 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: CA A112751) | |
| Enumeration Date | 2009-03-11 |
| Last Update Date | 2021-04-19 |