| NPI | 1578561189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: LA 021795) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 174400000X) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX 41385) | |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2012-10-08 |