| NPI | 1003896051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AZ 34390) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 34390) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: AZ 34390) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2015-04-21 |