| NPI | 1760919815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: WI 101554) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 64729) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 64729) | |
| Enumeration Date | 2017-05-20 |
| Last Update Date | 2024-07-01 |