| NPI | 1235124934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: SC 40013) |
| Additional Taxonomies | 207RH0003X Internal Medicine Hematology & Oncology (Licence: TX M7621) |
| 174400000X Specialist (Licence: VA 0101040855) | |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2020-11-05 |