| NPI | 1962474155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: IA 27148) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NE 19310) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2008-01-07 |