| NPI | 1851601264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: GA 006643) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT198167) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2014-01-03 |