| NPI | 1205099959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: WY 8962A) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX N3381) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2022-07-21 |