| NPI | 1376779413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: ID M-12810) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD156966) |
| 207R00000X Internal Medicine (Licence: NH 15628) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD.MD.60535666) | |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2015-10-20 |