| NPI | 1437125960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA G36649) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD041516L) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OH 35039199) | |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2008-06-06 |