| NPI | 1487938031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PR 18342) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 18342) |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2015-08-03 |