| NPI | 1902820384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 236190) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A91634) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A91634) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 231656) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2012-07-31 |