| NPI | 1124000278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA OS011961) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 042818) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2011-06-20 |