| NPI | 1740371194 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME1133396) | 
| Additional Taxonomies | 207RH0000X Internal Medicine, Hematology (Licence: NY 191073) | 
| Enumeration Date | 2006-09-28 | 
| Last Update Date | 2012-07-16 |