| NPI | 1215064654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 237235) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-228263) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2012-03-13 |