| NPI | 1215140454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME143428) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL L2568) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MD D70907) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MT191302) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-05-14 |