| NPI | 1356440762 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 39647)  | 
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: MA 39647)  | 
| Enumeration Date | 2006-09-22 | 
| Last Update Date | 2011-10-25 |