| NPI | 1366493991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: IA 24645) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 26579) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: IA 036-05398) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2020-06-11 |