| NPI | 1689671455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MI 4301054459) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: RI MD10207) |
| 208000000X Pediatrics (Licence: MI 4301054459) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2014-01-24 |