| NPI | 1164532107 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OR MD186731) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 40610) | 
| Enumeration Date | 2006-08-30 | 
| Last Update Date | 2020-04-17 |