| NPI | 1780674036 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: OR DO150591) | 
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: VA 0102201143) | 
| Enumeration Date | 2005-10-27 | 
| Last Update Date | 2021-08-05 |