| NPI | 1083665061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KY 17391) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TN MD0000020188) |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2014-01-13 |