| NPI | 1770682338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX M1686) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A102616) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2012-08-27 |