| NPI | 1679564322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 30751) |
| Additional Taxonomies | 207RH0000X Internal Medicine, Hematology (Licence: MA 30751) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2007-07-08 |