| NPI | 1306966783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: FL ME110028) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57012240) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 66390) | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2020-08-31 |