| NPI | 1124026406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CT 24011) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 24011) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2010-02-09 |