| NPI | 1508246042 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA 19762)  | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA 125066211)  | 
| Enumeration Date | 2015-05-30 | 
| Last Update Date | 2022-06-14 |