| NPI | 1770565871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MT 10533) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: MT 10533) |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: WY 7008A) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WY 7008A) | |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2010-09-08 |