| NPI | 1144430992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME112407) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-7754) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: IN 01066391A) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2012-08-06 |