| NPI | 1750511051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KY 49132) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301093900) |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2016-08-01 |