| NPI | 1215096912 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: TX M8738) | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL TRN6942) | 
| Enumeration Date | 2006-12-08 | 
| Last Update Date | 2019-10-07 |