| NPI | 1790703742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA G63119) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G63119) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2010-03-25 |