| NPI | 1720046097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OR MD154615) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 1376-TEP) |
| 207R00000X Internal Medicine (Licence: WI 50181-20) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2011-06-14 |