| NPI | 1205996014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TN MD0000046093) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2006-01338) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2012-10-31 |