| NPI | 1659375392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TN 24886) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MS 18531) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2011-02-24 |