| NPI | 1710968219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MT 7719) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WY 5703A) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2010-09-08 |