| NPI | 1700049707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MD D0079392) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.054711) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2016-04-19 |