| NPI | 1649634486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: TX BP10068537) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.027720) |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2021-06-30 |