| NPI | 1861489932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KY 27623) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD462984) |
| 207R00000X Internal Medicine (Licence: GA 035073) | |
| 207RH0000X Internal Medicine, Hematology (Licence: PA MD462984) | |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2018-12-12 |