| NPI | 1801046867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A112439) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: MO 2008014384) |
| Enumeration Date | 2008-09-26 |
| Last Update Date | 2018-11-19 |