| NPI | 1700854718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: CT 69932) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 154554) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2022-02-04 |