| NPI | 1386627040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 11042) |
| Additional Taxonomies | 174400000X Specialist (Licence: SC 2011042) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: SC 11042) | |
| Enumeration Date | 2005-11-26 |
| Last Update Date | 2013-05-09 |