| NPI | 1790766392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: WI 46235) |
| Additional Taxonomies | 207RA0000X Internal Medicine Adolescent Medicine (Licence: WI 46235) |
| 207RX0202X Internal Medicine Medical Oncology (Licence: WI 46235) | |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2024-05-07 |