| NPI | 1114922606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A29318) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: CA A29318) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2014-05-01 |