| NPI | 1740274117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: KY 33289) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: OH 35.033591) |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: IN 01037532A) | |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2014-09-17 |