NPI | 1710122601 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TN 54662) |
Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MS 24798) |
207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 003406) | |
Enumeration Date | 2008-12-08 |
Last Update Date | 2018-09-12 |