| NPI | 1811908965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: OH 35090582) |
| Additional Taxonomies | 207RH0003X Internal Medicine Hematology & Oncology (Licence: MN 102645) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2011-06-28 |