| NPI | 1174611750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A35871) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A35871) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2020-04-22 |