| NPI | 1124021142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MO R3A25) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KS 04-19790) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2016-12-29 |