| NPI | 1720067846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: CT 017804) |
| Additional Taxonomies | 174400000X Specialist (Licence: CT 017804) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CT 017804) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2015-12-28 |