| NPI | 1063513224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: MN 53593) |
| Additional Taxonomies | 207RH0003X Internal Medicine Hematology & Oncology (Licence: VA 0101235242) |
| 207RH0003X Internal Medicine Hematology & Oncology (Licence: KY 42603) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2011-04-28 |