NPI | 1124245618 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MO 2012014545) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 5155) |
208000000X Pediatrics (Licence: NE 5155) | |
207RH0003X Internal Medicine, Hematology & Oncology (Licence: KY 42699) | |
Enumeration Date | 2007-04-19 |
Last Update Date | 2012-10-30 |