| NPI | 1891793006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME103867) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: LA 04462R) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2009-11-10 |