| NPI | 1376520254 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AL 30196) | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NE 22433) | 
| Enumeration Date | 2005-12-30 | 
| Last Update Date | 2022-06-15 |