| NPI | 1588788921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: GA 080101) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CT 046185) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 209710) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2018-04-02 |