| NPI | 1215145560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD60366192) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT185593) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AZ 40088) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2016-08-23 |