| NPI | 1972552784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G78262) |
| Additional Taxonomies | 207RX0202X Internal Medicine Medical Oncology (Licence: CA G78262) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2007-07-09 |