| NPI | 1023015351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OH 35038120) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MI 4301058940) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2012-05-01 |