| NPI | 1114961091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PR 13250) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2016-08-19 |