| NPI | 1528056389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA C55286) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 11201) |
| 207RH0000X Internal Medicine, Hematology (Licence: NV 11201) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AL 28392) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KY 43954) | |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2012-11-26 |