| NPI | 1528359130 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CT 064378)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 064378)  | 
| 207RH0000X Internal Medicine, Hematology (Licence: CT 064378)  | |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: CT 064378)  | |
| Enumeration Date | 2011-04-29 | 
| Last Update Date | 2019-11-15 |