| NPI | 1790902393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: GA 060210) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 000467) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2012-10-25 |