| NPI | 1871506733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX n7643) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 48715) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2021-08-18 |