| NPI | 1659361327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: MA 36776) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 36776) |
| 207RH0000X Internal Medicine, Hematology (Licence: MA 36776) | |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2011-12-07 |