| NPI | 1891785341 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: CT 012338) | 
| Additional Taxonomies | 207RH0000X Internal Medicine, Hematology (Licence: CT 012338) | 
| Enumeration Date | 2005-10-26 | 
| Last Update Date | 2014-10-24 |