| NPI | 1700962677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: MI 4301062144) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301062144) |
| 208000000X Pediatrics (Licence: MI 4301062144) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2012-04-04 |