| NPI | 1811158942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TN 53413) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 071827) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2015-10-02 |