| NPI | 1245432467 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: MA 258434) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD13347) | 
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 258434) | |
| Enumeration Date | 2007-06-01 | 
| Last Update Date | 2014-07-21 |