| NPI | 1720233018 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AZ 74661)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 69611)  | 
| 207R00000X Internal Medicine (Licence: FL ME120878)  | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AL 31179)  | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CO CDR.0002408)  | |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: FL ME120878)  | |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: MN 69611)  | |
| Enumeration Date | 2008-12-01 | 
| Last Update Date | 2024-10-07 |