| NPI | 1437117454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G61618) |
| Additional Taxonomies | 207RH0000X Internal Medicine Hematology (Licence: CA G61618) |
| 207RX0202X Internal Medicine Medical Oncology (Licence: CA G61618) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2012-08-20 |