| NPI | 1023111572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME129380) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 21975) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MO 2010017185) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WV 21975) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2017-01-05 |