| NPI | 1922396753 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: VA 0101262567) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT198609) | 
| Enumeration Date | 2011-07-13 | 
| Last Update Date | 2021-09-21 |