| NPI | 1306887302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 155205) |
| Additional Taxonomies | 207RH0000X Internal Medicine Hematology (Licence: MA 155205) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2007-07-08 |