| NPI | 1568621779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101251504) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A 104157) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MD D73379) | |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2015-10-08 |