| NPI | 1619961026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KY 29476) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: KY 29476) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2008-08-19 |