| NPI | 1710250899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NE 27263) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 106238) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 55639) | |
| Enumeration Date | 2012-02-20 |
| Last Update Date | 2014-10-01 |