| NPI | 1184622250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine Medical Oncology (Licence: KY 44782) |
| Additional Taxonomies | 207RH0003X Internal Medicine Hematology & Oncology (Licence: LA 11661R) |
| 207RH0003X Internal Medicine Hematology & Oncology (Licence: KY TP143) | |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2012-05-15 |