| NPI | 1083961528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 62630) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 40893) |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2014-09-11 |