| NPI | 1790218451 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: KY 61150)  | 
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: AZ R76035)  | 
| 207R00000X Internal Medicine (Licence: AZ R76035)  | |
| 207R00000X Internal Medicine (Licence: KY 61150)  | |
| Enumeration Date | 2017-04-09 | 
| Last Update Date | 2025-10-16 |