| NPI | 1932158615 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101254724) | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD023733E) | 
| Enumeration Date | 2006-05-09 | 
| Last Update Date | 2013-08-29 |