| NPI | 1114930435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A64619) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A64619) |
| 207R00000X Internal Medicine (Licence: CA A64619) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2020-01-03 |