| NPI | 1215087085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 238553) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 229110) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 229110) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2012-08-13 |