| NPI | 1578566410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KY 43862) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 49480) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KY TP385) | |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2020-11-10 |