| NPI | 1659312601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101015715) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MI 5101015715) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2010-06-09 |