| NPI | 1164465191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: MN 48933) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: MN 48933) |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: WI 49571-20) | |
| 207RH0000X Internal Medicine, Hematology (Licence: WI 49571-20) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2011-05-12 |