| NPI | 1568584670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: TX L6547) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: NE 23128) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2009-07-09 |