| NPI | 1023003456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL 0059983) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AL 16738) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2014-12-02 |