| NPI | 1811982390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KY TP505) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 25878) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2013-12-11 |