| NPI | 1922207547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME140216) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2016-00813) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2019-10-29 |