| NPI | 1962493551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: CA a24132) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A24132) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2011-10-06 |