| NPI | 1932162369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: WI 27296-020) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 29043) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2011-09-15 |