| NPI | 1831280973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 250750) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VT 042-0011139) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2012-08-14 |