| NPI | 1548367204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine Medical Oncology (Licence: MI 4301095133) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M0504) |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2023-01-03 |