| NPI | 1780691238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PR 13846) |
| Additional Taxonomies | 261QX0200X Clinic/Center, Oncology (Licence: PR 13846) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-08-02 |