| NPI | 1619036621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C22547) |
| Additional Taxonomies | 207RH0000X Internal Medicine Hematology (Licence: CA C22547) |
| 207RH0003X Internal Medicine Hematology & Oncology (Licence: CA C22547) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2007-10-10 |