| NPI | 1487662052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME0029965) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX c9324) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2007-07-08 |