| NPI | 1518129121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME108049) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036116059) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2012-12-14 |