| NPI | 1871544619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 56851) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 46851) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2012-01-26 |