| NPI | 1558392175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 27985) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: WI 34879-20) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2021-07-15 |