| NPI | 1154647683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MD D47834) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA G077018) |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2010-04-09 |