| NPI | 1780857375 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: GA 074148) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VT 042-0012239) | 
| Enumeration Date | 2008-04-04 | 
| Last Update Date | 2015-10-08 |