| NPI | 1194700724 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: TX F7952) | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AZ 27946) | 
| Enumeration Date | 2005-12-06 | 
| Last Update Date | 2018-03-30 |