| NPI | 1760682835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX Q6242) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI 4301090767) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101248579) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TN 47337) | |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2015-10-16 |