| NPI | 1205812104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CO 0035987) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OR MD21314) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2016-01-27 |