| NPI | 1871687681 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NE 13385) | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: IA 23373) | 
| Enumeration Date | 2006-10-03 | 
| Last Update Date | 2013-07-10 |