| NPI | 1720158116 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: FL ME126669) | 
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: IL 36116430) | 
| Enumeration Date | 2006-11-09 | 
| Last Update Date | 2016-02-15 |