| NPI | 1679566178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: SC 12106) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 200100691) |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2012-06-13 |