| NPI | 1124187448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: CA 20A 5297) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA 20A 5297) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2007-07-08 |