| NPI | 1548538499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: AZ 1400) |
| Additional Taxonomies | 207RH0003X Internal Medicine Hematology & Oncology (Licence: CA 20A6986) |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2011-12-07 |