| NPI | 1619105830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: MA 276173) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q2196) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2018-10-09 |