| NPI | 1871594085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA A26702) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A26702) |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: CA A26702) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: CA A26702) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2010-04-22 |