| NPI | 1013128792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: SC 40329) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 632-L) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2019-10-18 |