| NPI | 1891807822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: WV 23735) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 002655) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2010-01-07 |