| NPI | 1962409235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: CO 38140) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CO 38140) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2013-04-04 |