| NPI | 1588836548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: SD 9500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 49919) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2015-08-14 |