| NPI | 1255490660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A26266) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A26266) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2015-09-08 |