| NPI | 1699792663 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A55916) | 
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: CA A55916) | 
| Enumeration Date | 2006-07-16 | 
| Last Update Date | 2019-09-03 |