| NPI | 1770665580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 19270) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VT 42-0009296) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2009-05-21 |