| NPI | 1700903242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101251920) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 2006-00276) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2006-00276) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2012-07-05 |