| NPI | 1053625632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MD D82266) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: DE C1-0008057) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD453377) | |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2016-12-05 |