| NPI | 1508153339 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A146863)  | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: LA 310726)  | 
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME154495)  | |
| Enumeration Date | 2011-06-30 | 
| Last Update Date | 2024-05-29 |