| NPI | 1649521618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 25804) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OK 17858) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2012-10-01 |