| NPI | 1487652665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CT 033368) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: CT 033368) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2014-07-08 |