| NPI | 1962406462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX D7369) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX D7369) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2017-03-24 |