| NPI | 1417036005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 45184) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KY 27870) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2008-09-26 |