| NPI | 1538418322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 17519) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: WI 17519) |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2012-09-07 |