| NPI | 1649205436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: VT 042-0011495) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: MA 80357) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2011-12-23 |