| NPI | 1063405082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA 55617) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.086827) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2016-06-27 |