| NPI | 1912097502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: MN 69429) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 69429) |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: UT 173374-1205) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2023-09-22 |