| NPI | 1548255755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101047415) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WV 21759) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2023-05-24 |