| NPI | 1215148754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101254576) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 202982) |
| 207R00000X Internal Medicine (Licence: LA MD.202982) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2013-09-19 |