| NPI | 1689848517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 2973609) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CT 53521) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2014-10-14 |