| NPI | 1477788099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: CT 039142) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: VT 042.0017216) |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2025-09-18 |